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Organization
SACRED LIFE RECOVERY SERVICES
Active
Organization
SACRED LIFE RECOVERY SERVICES
Active
Other names
Sacred Life Recovery Services
Organization subpart
No
Provider details
NPI number
Authorized official
RAEVAN SHEPHERD SUDCC (COUNSELOR)
(707) 295-2304
Entity
Organization
Contact information
Practice address
2681 LAKESHORE BLVD APT 7, LAKEPORT, CA 95453-6971
(707) 295-2304
Mailing address
495 N MAIN ST STE 128, LAKEPORT, CA 95453-4809
(707) 295-2304
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
09/19/2025
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